host: is that different from paul ryan's plan? guest: it is the same as paul ryan's plan. host: now that we have laid this all-out, let's turn to our viewers. vicky is up, a democratic caller. caller: good morning. i recently retired after 45 years of being a registered nurse in a hospital, and the first 10 years in a fee-for- service traditional hospital. the last 35 years, the oldest not-for-profit hmo in the country, kaiser permanente. i guess i am pretty upset about the fact that with all the spin about the affordable care act, nobody is really addressing a lot of the quality initiatives that have been included. it has been kind of perpetrated as basically an insurance program, when only 25% of it deals with insurance issues. the rest of it is really quality initiatives. there are 85 listed, such as national diabetes scorecards, giving providers some incentives and some reimbursements for electronic medical records, centers of excellence for things like congestive heart failure, a clinical depression. so can you address some of those quality initiatives? they are long